Risk factors for coronary heart disease are well documented for men
and women. The management of these risk factors is cost effective, but
it is generally ignored or pursued less vigorously in women than men.
Smoking: The incidence of smoking in young female adults of
age group 20-24 years has increased. The risk due to smoking increases
tremendously if there is combine consumption of oral contraceptives,
especially in women greater than 35 years of age.
Cholesterol: Raised level of total cholesterol and LDL
cholesterol are weakly associated with coronary heart disease in women.
Instead one should watch out for HDL cholesterol, as it is closely and
inversely related to coronary heart disease. Triglycerides, especially
in older women or diabetics, are also an independent predictor of
coronary heart disease.
Diabetes Mellitus: Diabetes is an exceptionally bad and
powerful risk factor for women. It increases the the risk of coronary
heart disease in women to three to seven folds, as compared with the
increase of two to three folds in men. Diabetes dramatically increases
the death rate of heart attack in women. Women have a higher prevalence
of diabetes mellitus than men.
Hypertension: The importance of hypertension (high blood
pressure) is similar in both men and women. Optimal high blood pressure
treatment can reduce the various complications such as death, stroke,
heart failure or coronary heart disease.
Stress: Acute and chronic stresses may play a contributory
role in the development of coronary heart disease or plaque rupture.
Depression and lack of social support may contribute partly to the
poorer outcome after cardiac events or cardiac surgery in women.
One of the best times to review and counsel women's risk factors is
during preconception period and pregnancy. Women should be strongly
discouraged to smoke and to avoid excessive weight gain. Advice on
nutrition, physical activity and stress management are also important
aspects in heart health counseling.